As we expected, both mosquito-borne illnesses have been reported in Tarrant County.

West Nile

On July 13, Tarrant County Public Health (TCPH) confirmed the first case of West Nile virus for the 2016 season. The case is from Bedford and is the severe form – West Nile Neuroinvasive Disease. More information is not being released to protect the patient’s identity.

Symptoms of the more severe form of West Nile include neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness and paralysis. This form of the disease can be deadly.

The mild form of the disease is commonly referred to as West Nile Fever. Symptoms include headache, fever, muscle and joint aches, nausea and fatigue. People typically recover on their own, although symptoms may last for several weeks.

“West Nile Virus infection is found in local mosquitoes. It is acquired from mosquito bites and not from infected people," said Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children's. "Most children who are infected with this virus do not develop symptoms. It has been circulating in mosquitoes in the United States for many years and is not new."

TCPH reminds us that we can protect ourselves from the West Nile virus through prevention and protection.

Reduce mosquito breeding sites:

• Dump mosquito breeding sites:
• Dump standing water
• Overturn containers
• Dispose of trash

Use dunks, bits and briquettes

Protect yourself:

• Use EPA-approved insect repellent
• Wear long sleeved shirts and pants

Zika

Tarrant County Public Health has identified two new imported cases of Zika, raising the total number to 11. There is still no local transmission in Texas.

The chance of a healthy child living in this area becoming ill with either of these viruses, West Nile or Zika, currently is "very, very, low," according to Dr. Whitworth. She said if Zika begins to circulate in local mosquitoes this may change, but it hasn’t yet. She adds that the best thing parents can do is help their children avoid mosquito bites. And if your child becomes ill and you have concerns, seek medical care. 

"Zika Virus is not currently circulating in local mosquitoes and so in this area it only occurs in returning travelers who are infected, their sexual partners, and, sadly sometimes their infants," Dr. Whitworth said. "Until this is circulating in local mosquitoes, the risk of infection here is very close to zero with this virus."

The chance of a healthy child living in this area becoming ill with either of these viruses currently is very, very, low. If Zika begins to circulate in local mosquitoes this may change, but it hasn’t yet. The best thing parents can do is help their children avoid mosquito bites. And if your child becomes ill and you have concerns, seek medical care. “

The first patient had traveled to Jamaica and the second patient to St. Lucia.

Harris County Public Health (HCPH) confirmed the first Zika related microcephaly case in the state of Texas. The mother had traveled from Latin America. The mother received inconclusive test results for Zika. The baby received a definitive positive lab result for Zika, which means the mom most likely carried the virus while pregnant and is thought to have been infected in Latin America.

Microcephaly, is a medical term for an abnormally small head. The causes of microcephaly can vary, but in this instance the small skull was directly related to abnormal fetal brain development.

The Centers for Disease Control and Prevention recommends “that all people, especially pregnant women, who are traveling to Brazil and other areas in Latin America, should take precautions to avoid mosquito bites to reduce their risk of infection with Zika virus and other mosquito-borne viruses such as dengue and chikungunya.”

The CDC asks that travelers protect themselves from mosquitoes by using insect repellent, wearing long sleeves and pants, and staying in places with air conditioning or that use window and door screens.

Related links:

• Tarrant County Public Health
• West Nile: What are the symptoms?
• How to fight and win against mosquitoes
• Will Zika affect your family?
• Zika: From nuisance to 'genuine threat to public health'
• Should we be afraid of Zika?
• Guillain-Barré syndrome: Are you at risk?
• 11 facts about the Zika virus
• The deets on DEET

Warren Marks, M.D., a neurologist and medical director of the Movement Disorders and Rehabilitation Programs at Cook Children’s, says he sees a dozen or more cases often in clusters.

“Influenza can be a trigger, so flu season often triggers some cases,” Dr. Marks said. “There have been some cases associated with mostly older flu vaccines, however in general, immunizations are safe and should be given as recommended. If you are concerned that your child is having progressive weakness, they should be seen by a physician.”

GBS is a condition that can follow many different infections. The process starts after the infection activates the immune system. Sometimes part of the bacteria or virus can look like our own nerves. If this happens, our immune systems can mistakenly attack those nerves which can lead to weakness or paralysis.

At this time, Dr. Marks is not ready to say there’s a relationship to GBS and the ZIka virus. Although it’s not out of the possibility – “there are literally thousands of potential triggers for Guillian Bare’. It is a nonspecific response to an infection.”

GBS can affect people of virtually any age, although it is rare in infants and toddlers. GBS symptoms usually begin with achiness of the muscles or a burning or tingling of the feet and legs.

“Weakness follows, beginning in the feet and progressing up the body, usually over the course of a few days,” Dr. Marks said. “It can occasionally happen more quickly. GBS can involve the diaphragm and breathing muscles which can be life threatening.”

In the mildest cases, monitoring of progress in the hospital is sufficient. If there is loss of ability to walk 100 feet or the weakness is progressing and breathing is endangered, the treatment is usually a five day course of IVIG (intravenous immunoglobulin). Steroids and plasma exchange are other options.

Related articles:

• Zika virus confirmed in Tarrant County
• 11 facts about the Zika virus
• Zika: From nuisance to genuine threat to public health

About the source

Warren Marks, M.D., is one of the the first two Endowed Chairs at Cook Children’s. Dr. Marks joined Cook Children’s in 1988 and today serves as the medical director for the Movement Disorder and Neurorehabilitation Program. Learn more about Dr. Marks and the contributions he's made to Cook Children's here.